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Update regarding Medicare's Provider Enrollment Revalidation - Cycle 2

Monday, November 21, 2016   (0 Comments)
Posted by: DCMS
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Provider Enrollment Revalidation Cycle 2

 

All Medicare providers are required to recertify the accuracy of their enrollment information every five years through a process known as revalidation. The initial five year revalidation cycle was completed in 2015 and the Centers for Medicare & Medicaid Services (CMS) began Cycle 2 in March 2016.

 

CMS implemented improvements to streamline the revalidation process during Cycle 2. One enhancement is that CMS is establishing due dates with six months of advance notice for when First Coast must receive your revalidation application to remain compliant. CMS posts the due dates for all currently enrolled providers in the Medicare Revalidation Lookup Tool at Data.CMS.gov/revalidation.

 

A due date of “TBD” means that CMS has not set the date yet. Please do not send a revalidation application if there is NOT a listed due date. First Coast will return any unsolicited revalidation applications received earlier than six months before the due date, or when a due date is not yet listed.

 

The Revalidation Lookup Tool is updated approximately every 60 days, so we encourage providers to check the tool periodically and respond timely once your due date is established. First Coast is also issuing notices by mail to you two-three months before the due date.

 

An important change for Cycle 2 is that failure to submit a revalidation application will result in deactivation of your Medicare enrollment and billing privileges. Deactivated providers will be required to submit a full and complete application in order to reactivate billing privileges. This will cause an interruption in billing during the deactivation period where you cannot receive reimbursement and you will be liable. Retroactive billing will not be granted once the billing privileges have been reactivated.

 

Please note other important impacts:

·         If the revalidation application is received, but additional information is requested (through development) and not received within the 30-day timeframe, your Medicare enrollment will be deactivated 

·         Requests for application submission extensions will not be granted

·         Be sure to submit the application fee, if applicable

 

Please access the following key resources for additional information:

 

·         MLN® Special Edition (SE) 1605 article

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1605.pdf

 

·         Steps for completing the revalidation process

http://medicare.fcso.com/PE_Revalidation/269940.asp

 

·         Revalidation Cycle 2 FAQs

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Downloads/Reval_Cycle2_FAQs.pdf

 

·         CMS’ Revalidations page
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Revalidations.html

 

·         First Coast’s on-demand webcast recording “Provider Enrollment Revalidation – Cycle 2”

https://gm1.geolearning.com/geonext/fcso/coursesummary.CourseCatalog.geo?src=CourseCatalog&selectTab=Details&id=22507369817  (Note: To access the recording, request a free training account at First Coast University).

 

This communication is from First Coast’s Provider Outreach and Education department. Please do not contact Customer Service regarding this email.

 

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